The major goals of this study are to: (1) estimate the economic costs of diagnosis and treatment of infertility, including both the direct costs of health services used to diagnose and treat infertility, and the indirect economic costs, such as those associated with time lost from work, financial burdens incurred to cover the costs of treatments, or non- medical resolutions to infertility, and to develop estimates of the cost- effectiveness of various treatment procedures; (2) estimate the personal and social costs of infertility, such as the ways in which infertility affects marital, family, and other social relationships, work and career choices, allocation of leisure time, activities undertaken or foregone; and (3) identify individual and treatment factors that may affect personal, social, and economic costs. The project will use the Infertility Cohort (described in detail in the Data Core proposal) of approximately 620 couples seen in 4 infertility practices as the data source. To estimate the direct medical costs of diagnosis and treatment of infertility, we will abstract medical records from all infertility service providers identified by patients or in medical records to assess detailed service utilization. To estimate out-of- pocket and indirect economic costs and social costs will also be obtained from personal interviews with Cohort members. From the patient's perspective, there is a crucial need for a comprehensive understanding of the costs of infertility, costs that may place a tremendous burden on the individuals affected. A more complete understanding of these costs may help individuals make more informed decisions concerning treatment and treatment options, an better prepare them to deal with the personal, social, and economic stresses imposed by infertility and its treatment. Finally, since research has found that physicians generally do not view infertility treatment as being as stressful, either physically or emotionally, as do patients, the information from this study may assist providers by providing a clear picture of the stresses of infertility that will aid them in their interactions with patients.